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INTRODUCTION: Phyllodes tumor (PT) of the breast, particularly malignant phyllodes tumor (mPT), is a rare fibroepithelial neoplasm. A complex diagnosis is based on pathologic, radiologic, and clinical findings, with controversies about what is the best therapeutic strategy. OBJECTIVE: Our objective was to provide an overview of the clinical, pathologic, and therapeutic aspects of this rare tumor. CONCLUSIONS: mPT is a rare presentation of breast cancer and a challenge in clinical practice. A multidisciplinary approach should take into account some aspects like pathogenic mutations and hereditary syndromes. Oncologic surgery is the fundamental approach, and the use of adjuvant therapies is still controversial due to the lack of clinical trials. Treatment recommendations should be individualized according to patient risk and preferences. Prospective studies are fundamental to clarifying the best treatment for these tumors.
RESUMO
The Vicryl mesh implantation after lumpectomy, which was first proposed in 2003, is a simple technique, less expensive than other proposed implantable biomaterials. However, the postoperative follow-up may be difficult, since the implanted mesh impairs the evaluation of surrounding breast parenchyma at both mammography and ultrasound. Magnetic resonance imaging can be used as a problem-solving tool if there are equivocal findings at physical exam, mammography, or ultrasound. Nevertheless, there are only few reports in literature about the imaging aspects of implanted absorbable mesh in the breast. The images presented in this case show the typical presentation of a foreign body granuloma associated with the Vicryl mesh. Breast radiologists and surgeons should be aware of these imaging aspects to avoid misdiagnosis and unnecessary additional exams.
A implantação da tela de Vicryl após quadrantectomia, proposta pela primeira vez em 2003, é uma técnica simples, sendo menos dispendiosa do que outros biomateriais implantáveis. Entretanto, o acompanhamento pós-operatório pode ser difícil, uma vez que a tela implantada compromete a avaliação do parênquima mamário adjacente, tanto na mamografia quanto na ultrassonografia. A ressonância magnética pode ser utilizada se houver achados duvidosos no exame físico, na mamografia ou na ultrassonografia. No entanto, existem poucos relatos na literatura sobre os aspectos de imagem da tela absorvível implantada na mama. As imagens apresentadas neste caso mostram a apresentação típica de um granuloma de corpo estranho associado à tela de Vicryl. Radiologistas e cirurgiões devem estar cientes desses aspectos de imagem para evitar diagnósticos incorretos e exames adicionais desnecessários.